Diagnostic value of HE4, CA125, ROMA INDEX and ultrasound findings in epithelial ovarian cancer

Background and aims: The aim of this study was to investigate the diagnostic values of risk of ovarian malignancy algorithm (ROMA), human epididymis protein 4 (HE4), cancer antigen 125 (CA125), menopausal status and ultrasound (US) findings for distinguishing benign from malignant pelvic mass. Methods: Serum CA 125 and HE4 levels were determined and the ROMA values were calculated in 40 women scheduled for surgery due to adnexal mass and in 30 healthy women, using Elecsys 2010 (Roche). Ultrasound findings were documented by experienced examiners. We used receiver-operator characteristic curve analysis. Sensitivity and specificity were calculated and the area under the curve was also assessed. Correlation between all methods was estimated using Spearman's rank correlation coefficient r. Results: The mean age of women with an adnexal mass was 52±14 years and the mean age of healthy women was 48±15 years. Only ROMA index was significantly higher in group of patients with adnexal mass compared to healthy patients (t-test: 2, 201 ; df=29, P=0, 036). In group of patients with adnexal mass ROMA index and serum HE4 level were significantly higher in postmenopausal patients, in patients with epithelial ovarian cancer (EOC) and in patients with three or more features from US findings (p=0.01-0.001), while serum CA125 level was significantly higher in patients with EOC and in patients with three or more features from US findings (p=0.001). Conclusion: Our study showed that using menopausal status and US findings in combination with ROMA index, HE4 and CA125, improve diagnostic accuracy for EOC.